Chapter 06: Maintaining Fluid Balance and Meeting Nutrition Needs My Nursing Test Banks

Wold: Basic Geriatric Nursing, 5th Edition

Chapter 06: Maintaining Fluid Balance and Meeting Nutrition Needs

Test Bank

MULTIPLE CHOICE

1. The nurse explains that the lowest recommended daily caloric intake to meet nutritional needs of the older adult safely is _____ calories.

a.

1000

b.

1200

c.

1400

d.

1800

ANS: B

The minimal caloric intake for the older adult that will meet nutritional needs of the older adult is 1200 calories.

DIF: Cognitive Level: Knowledge REF: 103 OBJ: 2

TOP: Minimal Calorie Intake KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

2. The 65-year-old woman brags that by using the MyPyramid guidelines for nutrition, she has lost 15 lb. The nurse reminds her that in order to maintain the weight loss, she must be physically active for _____ minutes a day.

a.

15 to 20

b.

20 to 30

c.

30 to 40

d.

40 to 60

ANS: D

According to the guidelines of MyPyramid, an activity period of 40 to 60 minutes a day is necessary to maintain weight loss.

DIF: Cognitive Level: Comprehension REF: 104 OBJ: 4

TOP: MyPyramid KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

3. The nurse recommends that the older man eat chicken and fish because these are complete proteins, which have:

a.

some molecules of carbohydrate.

b.

all the essential amino acids.

c.

high fat content.

d.

soluble fiber.

ANS: B

Fish and lean chicken have all the essential amino acids and very little fat content, unlike red meat.

DIF: Cognitive Level: Analysis REF: 106 OBJ: 2

TOP: Complete Protein KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

4. The nurse explains that high-density lipoproteins (HDLs), the so-called healthy fats, are made up of:

a.

mainly proteins.

b.

mostly triglycerides.

c.

mainly cholesterol.

d.

a variety of minerals.

ANS: A

HDLs are made up primarily of proteins, as opposed to lipids such as triglycerides, which are found in very-low-density lipoproteins (VLDLs) and cholesterol, which is found in low-density lipoproteins (LDLs).

DIF: Cognitive Level: Comprehension REF: 106 OBJ: 1

TOP: High-Density Lipoproteins KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

5. The nurse points out that the nonhealing pressure ulcers and decreasing visual acuity in a patient on a fat-restricted diet may be related to the patients impaired ability to metabolize vitamin:

a.

A.

b.

B6.

c.

B12.

d.

C.

ANS: A

Vitamin A is a fat-soluble vitamin and helps with wound healing and night vision acuity. Persons on low-fat diets may not be able to metabolize vitamin A from food sources because of the decreased fat in their diet.

DIF: Cognitive Level: Analysis REF: 106 OBJ: 6

TOP: Vitamin A Deficiency KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

6. The home health nurse does an ongoing assessment of the patient who has had a subtotal gastrectomy for evidence of a deficiency in vitamin:

a.

A.

b.

B6.

c.

B12.

d.

C.

ANS: C

Vitamin B12 is generated from the digestion of protein in the stomach. If part of the stomach is gone (gastrectomy), there is less digestive potential for vitamin B12.

DIF: Cognitive Level: Analysis REF: 106-107 OBJ: 3

TOP: Vitamin B12 Deficiency KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

7. The nurse giving an iron preparation in capsule form will improve its absorption by giving the patient extra:

a.

orange juice.

b.

milk products.

c.

water.

d.

caffeine drinks.

ANS: A

Vitamin C improves the absorption of iron.

DIF: Cognitive Level: Application REF: 109 OBJ: 8

TOP: Iron Administration KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

8. The nurse caring for the older adult patient who is taking a diuretic for control of hypertension should monitor the patient closely for signs of:

a.

hypokalemia.

b.

hypocalcemia.

c.

hyponatremia.

d.

hyperkalemia.

ANS: A

Diuretics deplete the body of potassium, a necessary mineral.

DIF: Cognitive Level: Application REF: 109 OBJ: 6

TOP: Hypokalemia KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

9. The older adult patient in an extended-care facility has a pressure ulcer. The nurse would encourage wound healing by increasing the patients intake of zinc from food sources such as:

a.

meat.

b.

citrus fruit.

c.

green leafy vegetables.

d.

complex carbohydrates.

ANS: A

Meat, nuts, and shellfish are dietary sources of zinc.

DIF: Cognitive Level: Application REF: 109 OBJ: 1

TOP: Zinc KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

10. The nurse is aware that older adults need a minimum daily fluid intake of _____ mL.

a.

1000

b.

2000

c.

3000

d.

4000

ANS: B

The minimum daily fluid requirement is 2000 mL/day.

DIF: Cognitive Level: Comprehension REF: 110 OBJ: 2

TOP: Fluid Requirements KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

11. Older adults who consume excessive amounts of alcohol put themselves at risk for nutritional deficits because alcohol:

a.

decreases blood glucose levels.

b.

alters the function of some minerals.

c.

interferes with the absorption of nutrients.

d.

increases the metabolism.

ANS: C

Excessive intake of alcohol interferes with the absorption of nutrients because of changes in the stomach lining.

DIF: Cognitive Level: Comprehension REF: 111 OBJ: 6

TOP: Factors Affecting Nutrition KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

12. The nurse in a retirement center who is selecting a main dish from the residents menu for an Orthodox Jewish man would select:

a.

crab cakes with white sauce.

b.

lamb chops with mint jelly.

c.

ham steak with red gravy.

d.

pork chops with cranberries.

ANS: B

Shellfish and pork are not permitted in the diet of Orthodox Jewish persons.

DIF: Cognitive Level: Analysis REF: 115 OBJ: 8

TOP: Cultural Factors KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

13. The nurse takes into consideration that the patient who would need higher caloric intake would be the patient with a condition such as:

a.

bacterial pneumonia.

b.

osteoporosis.

c.

arthritis.

d.

stroke.

ANS: A

Persons with infections require a higher caloric intake.

DIF: Cognitive Level: Application REF: 103 OBJ: 6

TOP: Changing Caloric Needs KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

14. The nurse explains that most older adults need only about 50 g of protein daily, which is equivalent to approximately _____ lb.

a.

1

b.

c.

d.

ANS: D

There are approximately 450 g in a pound, so 50 g is roughly equivalent to lb, essentially the weight of one thin hamburger patty.

DIF: Cognitive Level: Application REF: 104 OBJ: 2

TOP: Protein Intake Equivalent KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

15. The nurse instructing the older man in the use of MyPyramid points out that he should eat _____ cup(s) of fruit a day.

a.

b.

1

c.

d.

2

ANS: D

The MyPyramid guidelines recommend eating 2 cups of fruit daily.

DIF: Cognitive Level: Comprehension REF: 104 OBJ: 2

TOP: MyPyramid: Fruit KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

16. While instructing the patient who is to take oral iron supplements, the nurse indicates that:

a.

supplements should be taken between meals on an empty stomach.

b.

medication should be drunk from a nonmetal glass.

c.

the color of the stool will change to dark green or black.

d.

constipation is likely to occur.

ANS: C

Iron supplements can color the stool a dark green or black. Iron should be taken with a meal to reduce gastrointestinal irritation. The preparation should be taken through a straw. The supplement might cause diarrhea.

DIF: Cognitive Level: Comprehension REF: 109 OBJ: 8

TOP: Iron Preparations KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

17. When the nurse weighs an edematous patient with congestive heart failure, the weight increase from yesterday is 2.2 lb. The nurse assesses that this patient has retained _____ of fluid.

a.

500 mL

b.

1 L

c.

1500 mL

d.

2 L

ANS: B

The weight gain of 2.2 lb (1 kg) is equal to 1 L of fluid retention.

DIF: Cognitive Level: Application REF: 122 OBJ: 6

TOP: Fluid Retention KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

18. The nurse encourages a group of extended care residents to sit out on the sunny patio for an hour a day during the afternoon in order to help them with the synthesis of vitamin:

a.

A.

b.

B12.

c.

D.

d.

K.

ANS: C

Exposure to the sun allows the skin to synthesize vitamin D, which is required for calcium absorption.

DIF: Cognitive Level: Analysis REF: 107 OBJ: 8

TOP: Synthesis of Vitamin D KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

19. What is the caloric value (in calories per gram [cal/g]) of protein?

a.

9 cal/g

b.

4 cal/g

c.

0 cal/g

d.

7 cal/g

ANS: B

Proteins yield 4 cal/g.

DIF: Cognitive Level: Comprehension REF: 103 OBJ: 1

TOP: Calorie Values KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

20. What is the caloric value of alcohol?

a.

9 cal/g

b.

4 cal/g

c.

0 cal/g

d.

7 cal/g

ANS: D

Alcohol yields 7 cal/g.

DIF: Cognitive Level: Comprehension REF: 103 OBJ: 1

TOP: Calorie Values KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

21. What is the caloric value of vitamins?

a.

9 cal/g

b.

4 cal/g

c.

0 cal/g

d.

7 cal/g

ANS: C

Vitamins yield no calories.

DIF: Cognitive Level: Comprehension REF: 103 OBJ: 1

TOP: Calorie Values KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

22. What is the caloric value of fat?

a.

9 cal/g

b.

4 cal/g

c.

0 cal/g

d.

7 cal/g

ANS: A

Fats, which can come from either plant sources or animal sources, yield 9 cal/g.

DIF: Cognitive Level: Comprehension REF: 103 OBJ: 1

TOP: Calorie Values KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

MULTIPLE RESPONSE

1. The nurse takes into consideration the factors that influence nutritional needs, which include __________. (Select all that apply.)

a.

bone density

b.

gender

c.

climate

d.

presence of illness

e.

body temperature

ANS: B, C, D, E

Bone density is not a factor, but all other options are factors that have a significant effect on nutritional needs.

DIF: Cognitive Level: Comprehension REF: 102 OBJ: 2

TOP: Influences on Nutrition KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

2. The nurse uses a chart to show the vital nutrients required by all persons, which are __________. (Select all that apply.)

a.

carbohydrates

b.

proteins

c.

vitamins and minerals

d.

fats

e.

electrolytes

ANS: A, B, C, D

Electrolytes are not nutrients, but all other listed options are considered essential nutrients.

DIF: Cognitive Level: Knowledge REF: 103 OBJ: 2

TOP: Essential Nutrients KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

3. The nurse encourages older adults to include complex carbohydrates such as vegetables and fruits in their diet because complex carbohydrates contain __________. (Select all that apply.)

a.

minerals

b.

fats

c.

vitamins

d.

soluble fiber

e.

polysaccharides

ANS: A, C, D, E

No fat is contained in complex carbohydrates.

DIF: Cognitive Level: Comprehension REF: 104 OBJ: 1

TOP: Complex Carbohydrates KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

4. The nurse is aware that older adults who do not take in adequate fluids are at risk for __________. (Select all that apply.)

a.

altered absorption of drugs

b.

digestive disorders

c.

constipation

d.

bleeding disorders

e.

reduced appetite

ANS: A, B, C, E

Bleeding disorders are not associated with inadequate intake. All other options are problems associated with a fluid deficit.

DIF: Cognitive Level: Application REF: 109-110 OBJ: 6

TOP: Fluid Deficit KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

5. Older adults plagued with chronic health problems may become undernourished because they __________. (Select all that apply.)

a.

are too fatigued to prepare meals

b.

become frustrated when attempting to open packaging

c.

may be unable to carry groceries any distance

d.

have no interest in eating out due to health issues

e.

lack stamina to shop for groceries

ANS: A, B, C, E

Having no interest in eating out is not going to cause the older adult to be malnourished. Lack of interest in eating or socialization due to a chronic health problem can cause the older adult to be malnourished. All the other options listed can result in the older adult being malnourished.

DIF: Cognitive Level: Comprehension REF: 110 OBJ: 6

TOP: Factors Affecting Nutrition KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

6. The home health nurse is painfully aware that older adults living independently have many barriers to providing themselves with adequate nutrition, which include __________. (Select all that apply.)

a.

difficulty chewing

b.

lack of transportation to shop

c.

use of quick frozen meals

d.

lack of motivation to cook

e.

sensory changes

ANS: A, B, D, E

The availability of quick frozen foods, which are easy to prepare, offer a source of better nutrition to the older adult.

DIF: Cognitive Level: Application REF: 111 OBJ: 6

TOP: Factors Affecting Nutrition KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

7. An older adult who is a resident in an extended-care facility is at risk for nutritional deficits related to __________. (Select all that apply.)

a.

repetitive nature of meals

b.

lack of culturally significant food

c.

environmental odors

d.

reaction to being fed by others

e.

non-nutritious food choices

ANS: A, B, C, D

Although the food is nutritious, the repetitive nature of the menu, the lack of culturally significant food, and environmental concerns alter the motivation to have adequate intake.

DIF: Cognitive Level: Comprehension REF: 112 OBJ: 6

TOP: Factors Affecting Nutrition KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

8. The nurse suggests to the older adult that sources of protein that are less expensive than meat include __________. (Select all that apply.)

a.

corn

b.

beans

c.

whole-grain foods

d.

cheese

e.

nuts

ANS: B, C, D, E

Corn is not a source of protein.

DIF: Cognitive Level: Application REF: 106 OBJ: 1

TOP: Protein Consumption KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

9. The nurse cautions the older adult against taking excess vitamin supplements because some vitamins can be retained in fatty tissue and cause liver damage, including vitamin(s) __________. (Select all that apply.)

a.

A

b.

B6

c.

C

d.

D

e.

E

ANS: A, D, E

Excess fat-soluble vitamins A, D, and E can be retained in fatty tissue and result in hepatic damage.

DIF: Cognitive Level: Application REF: 108 OBJ: 1

TOP: Vitamin Intake KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

Copyright 2012 by Mosby, Inc., an affiliate of Elsevier Inc.

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